Saskatchewan Biosimilars Initiative: Information for Patients

About the Saskatchewan Biosimilars Initiative

• The Saskatchewan Biosimilars Initiative promotes the use of biosimilar versions of biologic drugs by individuals who require these medications.
• Under the Biosimilars Initiative, patients receive Saskatchewan Drug Plan coverage for the biosimilar version of a biologic medication where one is available and listed on the Saskatchewan Formulary.
• The Biosimilars Initiative will apply to future reference biologics as new biosimilars are added to the Saskatchewan Formulary. Updates will be communicated to health care professionals and patients on an ongoing basis.

Patients Affected by the Biosimilars Initiative

• The Biosimilars Initiative applies to patients who:
  
  • are newly starting, OR currently using a biologic medication on the List of Drugs Affected, AND
  • receive Saskatchewan Drug Plan coverage for this biologic medication.
• Please note that patients will continue to be able to access Saskatchewan Drug Plan coverage of their reference biologic medication if a suitable biosimilar format is not available.

Medications Affected by the Biosimilars Initiative

• Please see the List of Drugs Affected for the reference biologic medications currently affected by the Saskatchewan Biosimilars Initiative.
• The Biosimilars Initiative also applies to biologic medications included in previous transition period(s) (see Concluded Transition Periods).

Purpose of the Biosimilars Initiative

• Biosimilar medications are becoming available in Canada now that older reference biologic medications are losing their patent protections.
• Biosimilars are produced to the same quality as reference biologics but can be made at a much lower cost. Biosimilars cost less because they are based on work already done to develop the reference biologic medication.
• Using biosimilars presents a significant opportunity for cost savings and long-term health system sustainability while providing safe and effective medication options.
• Continued expansion of the Biosimilars Initiative supports patient access to public drug plan coverage.
• All provincial public drug plans across Canada have put similar policies in place to promote the uptake of biosimilar medications.

Transitioning to a Biosimilar Medication

• Patients should check the List of Drugs Affected to see if they need to use a biosimilar to maintain their Saskatchewan Drug Plan coverage of this medication.
• At your next appointment, talk to the health care provider who prescribed your current biologic medication. If you don’t have an appointment scheduled before the transition period ends, call their office to book one.
• You will need a new prescription for the biosimilar version of your medication because your pharmacy or clinic can only start the biosimilar with a new prescription.
• Discuss your questions about biosimilars with your doctor, nurse, or pharmacist.
• In some cases, you may have the option to enrol in a biosimilar patient support program (PSP). If applicable and appropriate, your health care provider can help you with this.

Patient Notification of Biosimilars Initiative

• Patients will be contacted directly by letter if they may need to start using a biosimilar version of their medication to keep Saskatchewan Drug Plan coverage of their treatment.
• Patients should contact their doctor, nurse, or pharmacist with questions about their treatment or about biosimilar medications.

Saskatchewan Drug Plan Coverage for Biosimilar Medications

• Patients who have Saskatchewan Drug Plan coverage for a reference biologic medication on the List of Drugs Affected will need to start using a biosimilar version before the end of the announced transition period.
• During the announced transition period, patients who are already using an affected biologic reference drug will have Saskatchewan Drug Plan coverage of both the reference biologic and biosimilar(s) listed on the Formulary.
• After the end of the transition period, the Saskatchewan Drug Plan will no longer cover the reference biologic medication unless a patient has an approved exemption.
• The cost of medication will vary based on an individual’s coverage, deductible and/or copayment.
• Please note that the Drug Plan will not cover up to the cost of the biosimilar if patients keep using the reference biologic after the end of the transition period. Patients will be responsible for the full cost of their reference biologic treatment unless they have an approved exemption.
• For questions related to drug coverage, contact the Drug Plan at 1-800-667-7581 or 306-787-3317 (Regina) or DPEB@health.gov.sk.ca.

Private Drug Coverage for Biosimilar Medications

• The Biosimilars Initiative applies to patients receiving Saskatchewan Drug Plan coverage of a reference biologic medication on the List of Drugs Affected and to biologic medications included in previous transition periods (see Concluded Transition Periods).
• Your private insurance provider may coordinate your benefits with the Saskatchewan Drug Plan.
• Contact your private insurance provider with questions about your private drug coverage benefits and how the Saskatchewan Biosimilars Initiative may apply to your private benefits.

Exemptions to the Biosimilars Initiative

• Exemptions for a patient to maintain coverage of a reference biologic will be considered for those who cannot use a biosimilar for a medical reason. Prescribers may submit an Exemption Request Form for review by the Drug Plan on a case-by-case basis.
• Prescribers and patients will be notified of exemption decisions directly by letter.
• Please note that patients will continue to be able to access Saskatchewan Drug Plan coverage of their reference biologic medication if a suitable biosimilar format is not available.

Preventing the Nocebo Effect

• Biosimilars work in the same way as the reference biologic; there are no clinically meaningful differences between the two medications.
• Biosimilar manufacturers submit studies to Health Canada and go through a rigorous process to prove that their biosimilar works as well and is as safe as the reference biologic.
• Patients can, therefore, expect the same therapeutic effect from biosimilars as the reference biologic.
• Science tells us that sometimes, our mindsets can influence our symptoms and sense of well-being. When negative expectations influence treatment outcomes, this is called the nocebo effect. Misinformation from a variety of sources can contribute to the nocebo effect.
• To prevent a nocebo effect, patients can:
  • Recognize the possibility of the nocebo effect
  • Find trustworthy information on biosimilars (see the Resources and Studies section)
  • Speak to their doctor, nurse, or pharmacist about biosimilar questions and options
  • Know that a growing number of patients around the world are safely using biosimilar treatments
  • Trust that your health care team is available if you have any questions or concerns about your treatment

Patient Supports

• Patients may contact their doctor, nurse, or pharmacist with questions about their treatment or about biosimilar medications.
• Many biosimilar manufacturers provide patient support programs (PSPs) and services similar to those of the reference biologic manufacturer to assist patients starting and transitioning to a biosimilar medication. See Patient Support Programs (PSPs) for more information.
• Patients can refer to the Information about Biologic and Biosimilar Medications, and the Resources and Studies sections of the Saskatchewan Biosimilars Initiative website for trustworthy information on biosimilar medications.
• medSask is a drug information service that provides accurate, evidence-based information on medications and medication therapy to the general public, healthcare providers, and other collaborators. medSask is available to support patients and health care providers with questions about biosimilar drugs. To contact medSask, patients may:
  
  • Visit the medSask website; or
  • Email med.sask@usask.ca; or
  • Call 1-800-665-3784 (306-966-6378 in Saskatoon).
• For general questions about the Saskatchewan Biosimilars Initiative, patients can contact the Drug Plan at sk.biosimilars@health.gov.sk.ca or call 1-800-667-2549 (306-787-8744 in Regina), and press 2, then 2.

Biosimilar Medications for Cancer Treatment

• The Biosimilars Initiative impacts biologics and biosimilars listed on the Saskatchewan Drug Plan Formulary and does not include those covered through the Saskatchewan Cancer Agency. 
• The Saskatchewan Cancer Agency is already using several biosimilar medications to treat various cancers.